Aibar-Durán Juan Á, Oladotun-Anka Michael, Asencio-Cortés Carlos, Valassi Elena, Webb Susan, Gras-Cabrerizo Juan R, Monserrat-Gili Joan, Ribó Pere Tresserras, Muñoz-Hernández Fernando
Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain), Autonomous University of Barcelona (AUB), Barcelona, Spain.
Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain), Autonomous University of Barcelona (AUB), Barcelona, Spain.
J Neurol Surg B Skull Base. 2021 Mar 2;83(Suppl 2):e274-e283. doi: 10.1055/s-0041-1725029. eCollection 2022 Jun.
Some complications have been more frequently reported after surgery for adrenocorticotropin hormone (ACTH)-secreting pituitary adenomas. We compared complication rates in patients with ACTH-secreting pituitary adenomas with those in patients with growth hormone secreting pituitary adenomas (growth hormone [GH] group) and nonfunctioning adenomas (nonfunctioning group). A comparative three-group analysis was performed for all patients who had endoscopic transsphenoidal surgery for pituitary adenomas at our center between January 2011 and May 2019. Variables included demographics, preoperative clinical and radiological characteristics, and postoperative radiological and endocrinological outcomes. Complications were divided into four categories: endocrinological, neurosurgical, medical, and ENT (ear-nose-throat)-related complications. Univariate and multivariate statistical analysis were performed. A total of 111 patients with pituitary adenomas and a mean age of 53.7 years were included (25 ACTH, 35 GH, and 51 nonfunctioning adenomas). Overall, 28 patients had microadenomas (25.2%) and 83 had macroadenomas (74.8%). Univariate statistical analysis for complications between groups showed no differences in neurosurgical and medical complications. Transient diabetes insipidus and postsurgical bacterial sinusitis were the only variables more frequently seen in the ACTH group ( = 0.01 and 0.04, respectively). Multivariate analysis for transient diabetes insipidus showed no differences between groups ( = 0.58). Complication rates were similar in all three adenoma groups, particularly concerning major infections, thrombotic events, postoperative cerebrospinal fluid (CSF) leak, and transient diabetes insipidus. Transient diabetes insipidus was related with adenoma size and intraoperative CSF leak. Despite postoperative bacterial sinusitis was statistically higher in the ACTH group, this data should be interpreted with caution given the low number of patients with this complication.
促肾上腺皮质激素（ACTH）分泌型垂体腺瘤手术后，一些并发症的报告更为频繁。我们比较了ACTH分泌型垂体腺瘤患者与生长激素分泌型垂体腺瘤患者（生长激素[GH]组）和无功能腺瘤患者（无功能组）的并发症发生率。
对2011年1月至2019年5月期间在我们中心接受垂体腺瘤内镜经蝶窦手术的所有患者进行了三组比较分析。变量包括人口统计学、术前临床和放射学特征，以及术后放射学和内分泌学结果。并发症分为四类：内分泌、神经外科、内科和耳鼻喉（ENT）相关并发症。进行了单因素和多因素统计分析。
共纳入111例垂体腺瘤患者，平均年龄53.7岁（25例ACTH腺瘤、35例GH腺瘤和51例无功能腺瘤）。总体而言，28例患者为微腺瘤（25.2%），83例为大腺瘤（74.8%）。组间并发症的单因素统计分析显示，神经外科和内科并发症无差异。短暂性尿崩症和术后细菌性鼻窦炎是ACTH组中仅有的更常见变量（分别为P = 0.01和0.04）。短暂性尿崩症的多因素分析显示组间无差异（P = 0.58）。
所有三个腺瘤组的并发症发生率相似，尤其是在严重感染、血栓形成事件、术后脑脊液（CSF）漏和短暂性尿崩症方面。短暂性尿崩症与腺瘤大小和术中脑脊液漏有关。尽管ACTH组术后细菌性鼻窦炎在统计学上较高，但鉴于该并发症患者数量较少，该数据应谨慎解读。
